The effect of a novel core stabilization technique on managing patients with chronic low back pain: a randomized, controlled, experimenter-blinded study

Objective: To identify the effect of a novel augmented core stabilization exercise technique on physical function, pain and core stability in patients with chronic low back pain. Design: A block randomized controlled trial with two groups. Setting: A sports rehabilitation clinic. Participants: Forty patients with low back pain (20 experimental, mean (SD) age 50.35 (9.26) years and 20 control, 51.30 (7.01)), 19 men and 21 women. Interventions: In the experimental group ankle dorsiflexion was used in addition to drawing in the abdominal wall; the control group involved drawing in the abdominal wall alone. Both groups received the same conventional physical therapy training three days a week for eight weeks. Main outcome measures: Physical disability instruments; Oswestry Disability Index and Roland Morris Disability Questionnaire; pain intensity assessments; visual analogue scale, Pain Disability Index, and a pain rating scale; and core stability measures, such as the active straight leg raise, were determined at pretest, posttest and two-month follow-up. Results: After the intervention, the experimental group showed significant greater improvement at two months compared with the control group. Physical disability results included Oswestry Disability Index (P = 0.001, from 24.25 (7.08) to 13.35 (4.17)) and Roland Morris Disability Questionnaire (P = 0.001, from 15.55 (1.99) to 8.15 (1.69)), pain intensity including visual analogue scale (P = 0.001, from 6.30 (1.03) to 3.35 (0.59)), Pain Disability Index (P = 0.001, 31.25 (5.44) to 19.00 (3.58)) and pain rating scale (P = 0.001, from 72.25 (18.73) to 50.10 (15.47)), and the core stability test such as active straight leg raise (P = 0.001, from 7.40 (0.75) to 2.15 (0.49)). Conclusions: This study provides the clinical evidence that adding ankle dorsiflexion to drawing in the abdominal wall gave increased benefit in terms of physical disability, pain and core stability in patients with chronic low back pain.